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Sparse trees conceal the entrance. One descending timber tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, doctors monitor a display. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Hospital personnel at an underground medical center look at a screen displaying Russian suicide and reconnaissance UAVs in the region.

This is the nation's secret underground hospital. This center began operations in the eighth month and is the second of its kind, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the safest way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a each day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or severe abdominal injuries. Others can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with deadly precision. “90% of our cases are from first-person view drones. We encounter few bullet injuries. This is an age of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the underground installation for treating injured soldiers in eastern Ukraine.

On one afternoon recently, three military members limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “War is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a another explosive on him.” He continued: “All structures in the village is demolished. We see drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions came by drone: rations and water. A week following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his physical condition. After treatment, a nurse gave him new civilian clothes: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, stated a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous detonations.” A construction worker working in Lithuania, he noted he had returned to Ukraine and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors placed him on a bed, removed a stained bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A fragment of mortar struck me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to go back to my unit. Our forces must protect our country,” he said.

Medical staff care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and ambulances. According to international monitors, 261 health workers have been killed in almost two thousand attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and granular material placed above reaching ground level. It can withstand impacts from 152mm projectiles and even three 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which funded the construction, plans to erect twenty facilities in total. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “critically important for preserving the lives of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented since the enemy's invasion.

One of the centre’s operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays hours or even days before they could be transported because of the danger of air assaults. “We had two critically ill casualties who came at the early hours. It was necessary to carry out a removal of both limbs on one of them. His tourniquet had been on for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for 20 years. You have to focus,” he remarked.

Medical assistants transported the soldier up the tunnel and into an ambulance. The transport was parked under a shrub. He and the other military members were taken to the urban center of a major city for additional medical care. The underground medical team paused for rest. The facility's orange feline, the mascot, padded toward the entrance to greet the next arrivals. “Our facility operates open around the clock,” Holovashchenko stated. “It doesn’t stop.”